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Biomedical subjects

R A Turner

Publications and source records attributed to R A Turner.

At least 19 recordsLinked to original sources

Predictive validity of WAIS-R VIQ-PIQ splits in persons with major depression.

We selected a sample of patients with depression (N = 70) and used Bayesian analyses to examine the diagnostic predictive validity of the Wechsler Adult Intelligence Scale-Revised Verbal IQ (VIQ) minus Performance IQ (PIQ) difference score for depression. The patients showed average VIQ-PIQ differences in the expected direction (i.e., VIQ > PIQ). However, based on sensitivity, specificity, and positive predictive value statistics, we concluded that the VIQ-PIQ split has very low predictive validity in persons with depression.

Adult↗

Preliminary research on plasma oxytocin in normal cycling women: investigating emotion and interpersonal distress.

The neurohormone oxytocin is responsible for initiating childbirth and the let-down reflex in lactating women and is released during sexual orgasm. Oxytocin has been thought of as an affiliation hormone because research on nonhuman mammals has demonstrated that it plays a key role in the initiation of maternal behavior and the formation of adult pair bonds. It has been speculated that social stimuli may induce oxytocin release and that oxytocin may make positive social contact more rewarding. Data are presented from an initial study to examine change in plasma oxytocin in response to a standard imagery task that elicits emotion related to attachment. Twenty-five normal cycling, healthy women underwent imagery tasks and completed questionnaires on attachment and interpersonal problems. Blood draws (5 ml) were bone via an indwelling catheter before, during, and after three interventions (massage, positive emotion, and negative emotion) and to establish baselines. Overall, the data showed a tendency for oxytocin levels to be elevated in response to relaxation massage and decreased in response to sad emotion. There were individual differences in response to the interventions. Those who showed evidence of increased oxytocin levels for positive emotion and massage and who maintained oxytocin levels during negative emotion were less likely to report interpersonal problems associated with intrusiveness. Maintaining oxytocin levels during sadness was also correlated with lower anxiety in close relationships. Women who were in a couple relationship had greater increases in oxytocin in response to positive emotion. In contrast, higher basal levels of oxytocin were associated with greater interpersonal distress. These data suggest that peripheral secretion of oxytocin in response to emotional stimuli is associated with the individual's interpersonal characteristics.

Adult↗

Selective alteration of personality and social behavior by serotonergic intervention.

OBJECTIVE: The authors sought to test the causal hypothesis that serotonergic function modulates aspects of the normal spectrum of individual differences in affective experience and social behavior in humans. METHOD: A selective serotonin reuptake inhibitor (SSRI), paroxetine, 20 mg/day (N = 26), or placebo (N = 25) was administered to normal volunteers in a double-blind manner for 4 weeks, and personality variables and social behavior were assessed at baseline and at weeks 1 and 4 of treatment. RESULTS: Relative to placebo, SSRI administration reduced focal indices of hostility through a more general decrease in negative affect, yet did not alter indices of positive affect. In addition, SSRI administration increased a behavioral index of social affiliation. Changes in both negative affect and affiliative behavior were significantly related to volunteers' plasma SSRI levels at the end of the experiment. CONCLUSIONS: Central serotonergic function may modulate a dimension of normal personality characterized by reduced negative affective experience and increased affiliative behavior. SSRI administration has significant and detectable effects on these measures even in the absence of baseline clinical depression or other psychopathology.

Adult↗

The roles of constructive thinking and optimism in psychological and behavioral adjustment during pregnancy.

This study examined the impact of constructive thinking on the anxiety, positive states of mind, and substance use of 221 women during pregnancy and the influence of optimism and perceived stress on these relationships. Participants were interviewed both early and late in pregnancy. Constructive thinking predicted both psychological and behavioral adjustment later in pregnancy, independent of age and social desirability. Subsequent path analyses indicated that constructive thinking mediated the impact of optimism on anxiety, positive states of mind, and substance use during pregnancy. In turn, the effect of constructive thinking on women's adjustment during pregnancy was itself mediated by their perceived stress. Implications for constructive thinking and optimism as independent constructs relevant to adjustment and their potential importance for future research and clinical applications are discussed.

Adaptation, Psychological↗

Tenidap in patients with rheumatoid arthritis. A 4-week, placebo-controlled study.

The present double-blind, placebo-controlled study was conducted to compare the safety and efficacy of tenidap in patients with rheumatoid arthritis (RA). Patients with flare of active RA following NSAID withdrawal were randomized to receive either placebo (n = 67) or tenidap (n = 131; 40-200 mg/day). The mean changes from baseline in efficacy and biochemical variables were compared between treatment groups at endpoint (4 weeks). The improvements in four of the five primary efficacy variables were significantly greater in the tenidap group compared with the placebo group (p < 0.01). Tenidap was also associated with an 18% reduction in erythrocyte sedimentation rate (ESR) and a marked, 51%, reduction in serum C-reactive protein (CRP) level, both of which were significantly greater than the changes in the placebo group (p < 0.05). The percentage of patients who discontinued because of side effects was the same in both groups (3%). In conclusion, tenidap 40-200 mg/day was effective and well tolerated in the treatment of patients with RA for 4 weeks.

Administration, Oral↗

Joint space measurement in hand radiographs using computerized image analysis.

OBJECTIVE: To compare computerized joint space (JS) measurements with conventional joint space narrowing (JSN) scores in patients with mild rheumatoid arthritis. METHODS: Serial paired hand and wrist radiographs from 34 patients with classic rheumatoid arthritis were evaluated. Purpose-written software automatically measured the JS on test images and standard clinical hand radiographs; JSN was scored "blind" by 6 observers. RESULTS: The software proved reliable. JS values differed significantly (men > women; metacarpophalangeal > proximal interphalangeal joints), declining with disease duration more than with age; JSN scores correlated poorly and varied more. CONCLUSION: Computerization permits sensitive JS measurement and should be of benefit in studies of early joint disease.

Adult↗

Decreases in health care resource utilization in patients with rheumatoid arthritis following a cognitive behavioral intervention.

We previously reported the efficacy of a multicomponent cognitive-behavioral intervention including biofeedback to decrease pain, affective distress, and objective measures of disease activity in patients with rheumatoid arthritis (RA). In the present article we report evidence that this intervention is associated with reductions in RA-related clinic visits and days hospitalized as well as reductions in the costs of these medical services. Data were independently and objectively collected over an 18-month interval as part of a controlled group outcome study. The importance of documenting economic as well as clinical benefits of our treatments in specific patient populations is noted.

Arthritis, Rheumatoid↗

Pain behavior of rheumatoid arthritis patients enrolled in experimental drug trials.

OBJECTIVE: This study examined the sensitivity of a behavioral observation method for the assessment of arthritis pain as an outcome measure in clinical drug trials. METHODS: The subjects were 33 rheumatoid arthritis patients who were receiving either an active experimental drug or a placebo. Disease activity measures, self-reports of pain, and pain behavior observations were completed for each subject prior to drug initiation, 6 weeks after drug initiation, and 12 weeks after drug initiation. RESULTS: Significant reductions in measures of disease activity and self-report of pain were found for the subjects who received an active drug, relative to those who received the placebo. The pain behavior scores produced by both groups of subjects remained relatively stable during the study. CONCLUSION: The lack of change in pain behavior suggests that arthritis pain behavior may lack sensitivity to short-term changes accompanying drug therapy.

Arthritis, Rheumatoid↗

Initiation of substance use in early adolescence: the roles of pubertal timing and emotional distress.

Two hypotheses regarding the effects of pubertal timing on substance use were tested in a prospective study of 221 young adolescents. A maturational-deviance hypothesis predicted that early-maturing girls and late-maturing boys would experience heightened emotional distress, which in turn would influence initiation and use of substances. Alternatively, an early-maturation hypothesis predicted that early-maturing girls would engage in more substance use than all other groups, independent of emotional distress. Early-maturing adolescents reported more substance use within 1 year. Adolescents experiencing elevated levels of negative affect also reported greater substance use within the next year. However, pubertal timing was not related to emotional distress. Results support the early-maturation hypothesis for girls and suggest its extension to boys.

Adolescent↗

Autonomy, relatedness, and the initiation of health risk behaviors in early adolescence.

This study examined the relationships among sociodemographic characteristics, family processes, and the initiation of health risk behaviors in early adolescence. Subjects were 189 6th and 7th graders from a public middle school. A path-analytic model was used to analyze data. Results showed that students who received autonomy support from parents were less likely to initiate sexual intercourse. Students who were emotionally detached from their parents were more likely to fight and use substances. Those who were emotionally detached tended to come from families with low levels of cohesion and acceptance. Sociodemographic variables, such as family structure, gender, and ethnicity, had both direct and indirect effects on health risk behaviors, but the indirect effects were quite small.

Adolescent↗

Observation of pain behavior in rheumatoid arthritis patients during physical examination. Relationship to disease activity and psychological variables.

This study examined the reliability and validity of a behavioral observation method for the assessment of arthritis pain in a clinical practice setting. Trained observers measured the occurrence of seven pain behaviors in a group of 61 rheumatoid arthritis patients undergoing physical examinations. These observations were compared with videotaped observations of the patients in a laboratory setting. Significant differences were found between the pain behavior frequencies observed during the examinations and those observed during videotaped sessions. Total pain behavior scores obtained in both settings were significantly correlated with patients' self-reports of pain and with disease activity measures. Pain behavior observed during the exams was significantly associated with patients' self-reports of anxiety and depression.

Arthritis, Rheumatoid↗

Validity of self-report of pubertal maturation in early adolescents.

Self-report measures of sexual maturation continue to be used to classify pubertal development even though their reliability remains in question. This study examined the accuracy of self-report measures by early adolescents in two settings. Standardized figured drawings depicting Tanner's sexual maturation scale (SMS) were shown to early adolescents at school (S1) and again in a clinical sitting (S2), and subjects were asked to rate their own pubertal development. Physical examination by a physician at S2 was used to corroborate sexual maturation. Participating in the study were 46 males, age 11-14 years (mean, 12.4, SD, 1.9), and 37 females, age 11-14 years (mean, 12.7, SD, 0.7). Concordance rate between physical examination and self-report of pubic hair development (males) at S1 was 58% (kappa = 0.35, p less than 0.0001) and 78% (kappa = .66, p less than 0.0001) at S2. Concordance rate of self-report of genital development at S1 and S2 was 27% (kappa = -0.06, p less than 0.49) and 44% (kappa = 0.18, p less than 0.04), respectively. Self-report of breast development demonstrated a concordance rate of 59% (kappa = 0.43, p less than 0.0001) at S1 and 72% (kappa = 0.59, p less than 0.0001) at S2. Concordance rate for self-report of pubic hair development in females was 58% at S1 (kappa = 0.42, p less than 0.0001) and 75% at S2 (kappa = 0.64, p less than 0.0001). There was a tendency for subjects to overestimate their development at early stages of maturation and underestimate development at later stages.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Early adolescent knowledge and attitudes about circumcision: methods and implications for research.

The psychosocial effects of circumcision status on the adolescent male are unclear. This study explored methods for assessing attitudes toward circumcision of early adolescents and differences in satisfaction between circumcised and uncircumcised males that would warrant further investigation. Seventy-three boys, aged 11 through 14 years completed the Petersen Body Image Scale and a questionnaire concerning their own circumcision status, satisfaction with that status, and perceptions about the status of other family members and peers. To assess knowledge, subjects identified diagrams depicting differing circumcision states during a personal interview. Physical examination confirmed reported circumcision status. Of the study group, 19% (n = 14) were uncircumcised. Use of visual aids to report circumcision status was more accurate (92%) than self-report (68%). Circumcised boys scored higher on satisfaction items than did uncircumcised boys, (t(15.65) = -3.96, p less than 0.001). No differences in general body image were found between groups. Further research that examines psychosocial outcomes of circumcision status is necessary.

Adolescent↗

Biochemical perturbations of BW 91Y (3-deazaadenosine) on human neutrophil chemotactic potential and lipid metabolism.

The studies reported here were designed to examine the chemotactic potential, arachidonic acid (AA) metabolism and phospholipid transmethylation in peripheral blood neutrophils from patients with rheumatoid arthritis (RA): a) prior to treatment with BW 91Y (3-deazaadenosine), b) after 4 weeks when half the patients were on active medication and half were on placebo, and c) after 4 weeks at which time all patients were on active medication. The authors demonstrate that BW 91Y in vitro at 600 pg/ml caused a decrease in chemotactic potential as measured by the leading front (LF) assay in neutrophils from both normal volunteers (p less than 0.025) and RA patients. They also demonstrate that BW 91Y caused a significant increase in production of [3H]LTB4 (LTB = leukotriene B) in ionophore-stimulated neutrophils from both normal (p less than 0.025) and RA patients (p less than 0.050) as compared to initial values. BW 91Y caused decreased incorporation and percent distribution of [3H]AA into phosphatidylcholine (PC), with a resultant increase in percent distribution into phosphatidylethanolamine (PE). There was also an increased release of [3H]AA from the PE fraction in BW 91Y-treated cells in response to ionophore stimulation. BW 91Y was found to exhibit a dose-dependent (10(-7) to 10(-4) g/ml) inhibition of the uptake and incorporation of L-[methyl-3H]methionine into the cellular lipids, while at low doses (10(-9) to 10(-5) g/ml) it stimulated the significant uptake and incorporation of [methyl-14C]choline chloride into PC. Although the total cellular content and percent composition of PC remained unchanged, it was found that BW 91Y caused a slight decrease in PC plasmalogens and an apparent increase in the 1,2-diacyl-glycerophosphatidylcholine (-GPC). BW 91Y was found, however, to have no effect on the amount or stimulated metabolism of the ether-linked 1-O-alkyl-2-acyl-GPC. As further evidence for this, the authors demonstrate that BW 91Y has no effect on the ionophore-stimulated production of [14C]acetate-labelled 1-O-alkyl-2-acetyl-GPC, or [14C]PAF.

Arachidonic Acids↗

Evaluation of Tenidap (CP-66,248) on human neutrophil arachidonic acid metabolism, chemotactic potential and clinical efficacy in the treatment of rheumatoid arthritis.

Ten patients with rheumatoid arthritis (RA) were evaluated in a placebo-controlled, double-blind study examining the clinical efficacy of a novel nonsteroidal anti-inflammatory agent: Tenidap (CP-66,248). RA patients receiving active drug therapy (n = 6) demonstrated clinically significant improvements in observer assessment of pain (p less than 0.025), painful joint count (p less than 0.010), and overall clinical assessment as based on a modified rheumatoid activity index, MRAI (p less than 0.025). In parallel laboratory assays, Tenidap was found to exhibit a significant in vitro dose-dependent inhibition of ionophore-stimulated neutrophil production of the 5-lipoxygenase product: [3H]leukotriene B4 (LTB4). Although more importantly, Tenidap was also found to exhibit an in vitro dose-dependent inhibition (IC50 20 microM) of the ionophore-stimulated release (deacylation) of the precursor [3H]arachidonic acid (AA) from membrane phospholipids. In further studies, Tenidap did not have any effect on fMLP-induced neutrophil chemotactic response. These results suggest that one of the possible mechanisms for the clinical effectiveness of this agent, may be through its effect at inhibiting the release of free AA from membrane phospholipids and therefore limiting its further metabolism into certain biologically-active inflammatory lipids.

Anti-Inflammatory Agents, Non-Steroidal↗

Neutrophil functional and arachidonic acid metabolic correlates and clinical disease activity in pirazolac-treated rheumatoid arthritis patients.

Neutrophils from 20 medication-free rheumatoid arthritis patients were chemotactically hyporesponsive to 2 x 10(-8) M formyl-methionyl-leucyl-phenylalanine (f-MLP) as compared to 20 normal controls. They were relatively high producers of 5-hydroxyeicosatetraenoic acid (5-HETE) and low producers of leukotriene C4 (LTC4). Neutrophils from 10 patients treated with pirazolac (4-(4-chlorophenyl)-1-(4-fluorophenyl)-5-pyrazole acetic acid) showed increased chemotactic responsiveness concomitantly with normalization of 5-HETE and LTC4 production and a decrease in the clinical parameters of disease activity. Clinically attainable (30-60 micrograms/ml) in-vitro doses of pirazolac further depressed the chemotactic responsiveness of normal neutrophils treated with 10(-5)M f-MLP. Effects on endothelial gating of migrating neutrophil populations may explain this apparent contradiction between in-vivo and in-vitro actions of pirazolac on neutrophil chemotaxis.

Anti-Inflammatory Agents, Non-Steroidal↗